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Awakenings Christian Counseling 4250 S. Westside Kalamazoo MI 49008Email: counsel awakeningscc.com Phone: 2692342343 CHILD / ADOLESCENTINTAKE ASSESSMENTDate Child's name Address DOB City State Zip
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Start by opening the adolescent intake form acc.
02
Read the instructions at the beginning of the form.
03
Provide the required personal information, such as name, date of birth, and contact details.
04
Answer the questions about medical history and any current health concerns.
05
Provide information about any medications or supplements being taken.
06
Indicate any allergies or previous adverse reactions to medications.
07
Answer questions about mental health history and any current concerns.
08
If applicable, provide information about previous therapy or counseling.
09
Answer questions about family history of mental health conditions.
10
Provide any additional details or concerns that you think are important.
11
Review the filled-out form for accuracy and completeness before submitting.
12
Submit the completed form to the appropriate recipient.

Who needs adolescent intake form acc?

01
Adolescent intake form acc is needed by healthcare professionals, such as doctors, therapists, or counselors, who work with adolescents.
02
It is also needed by parents or legal guardians who are seeking mental health services for their adolescent children.
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The adolescent intake form acc is a document designed to gather information about adolescents for a specific purpose.
Adolescents and their legal guardians are required to fill out and file the adolescent intake form acc.
To fill out the adolescent intake form acc, one must provide accurate information about the adolescent in the designated fields.
The purpose of the adolescent intake form acc is to collect relevant information about adolescents for assessment and record-keeping purposes.
Information such as personal details, medical history, behavioral observations, and any other relevant information about the adolescent must be reported on the adolescent intake form acc.
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